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Vegan and vegetarian athletes almost certainly need supplementation, as do those over 50 whose absorption naturally declines

Interestingly, dienogest was associated with an increased rate of spotting and weight gain, but alower rate of hot flashes and vaginal dryness compared to GnRH agonists [67]

This keeps homocysteine levels low, which is good for the heart

This observation aligns with intra-follicular endocrinology and intracrinology: the follicle is not a passive recipient of circulating signals, but actively shapes a compartmentalized steroid milieu through coordinated theca-granulosa steroidogenesis and local enzymatic conversion [252,253,254]